Related Media

In one recent simulated drill, members of the Nevada County Sheriff’s Special Enforcement Detail fanned out across a quad at Magnolia Intermediate School, searching for a student who had “shot” a number of classmates.

The simulation, using “dead” or “injured” students identified by white signs clutched to their sprawled-out bodies, bore eerie similarities to any number of tragic real-life school shootings.

But one aspect of the drill — which was organized by team member Steve Stanley to replicate a Columbine-type massacre — stood out.

Instead of a typical situation where ambulances and medical personnel wait helplessly on the periphery until areas have been cleared and the wounded can be safely evacuated, Stanley was immediately able to triage and “treat” the injured students.

Stanley is one of very few paramedics on SWAT teams in the area and, in fact, pioneered the concept in the region.

Having a medic on the team is an “invaluable resource, not just for the team and the department but for the community itself because we have a first responder right there,” said Sheriff’s Lt. Steve Tripp, the SED team commander. “When you’re dealing with life or death, seconds can make the difference. Someone to make entries with us in very stressful situations, it’s vital that the person can administer lifesaving first aid immediately to either a team member, a citizen or the suspect … If anyone is shot, sometimes we can’t evacuate that person, so it’s vital that we can provide care while we’re still in that house.”

Stanley, a reserve deputy, has been a member of the SED team for 12 years but has been a paramedic for 23 years.

He originally began working for the Grass Valley Fire Department in 1986 but soon got a “bug for the medical stuff.” He went to paramedic school in 1988 and worked in Los Angeles and Sacramento before starting to work for an ambulance service in Placer County.

“You don’t see a lot of old paramedics,” he said. “It’s a hard job. Most go on to something else, often to fire departments. The average burnout rate is five years … It’s such a great job — but you get tired.”

Unlike many of his buddies, however, Stanley opted for law enforcement.

At the time, having a paramedic on a SWAT team was a new concept, and very few departments had one.

“L.A. County was doing it, but you have to be really huge,” Stanley said.

Undeterred, Stanley went to the police academy part time starting in 1996, under the sponsorship of Rocklin’s police department.

He did join their SWAT team — but because of bureaucratic issues, he was not able to work as a paramedic on the team, he said.

“Nevada County has been nothing but 100 percent supportive. Props to them for doing what it took to make this happen.”

Because integrating a certified paramedic into a SWAT team had not been done before, the Sheriff’s Office had to go through the application process to start an ambulance service, although it doesn’t actually provide transport, Stanley explained.

“The process was much more onerous then; it was somewhat groundbreaking for our agency.”

When Stanley first approached the agency with the idea of tactical medicine, there were no state regulations in place, Pinette said.

“Since then, we have approved five other programs in our 10-county region,” she said.

It took more than a year to create the system and write the protocols and the policies, Stanley said.

Dr. Dave Duncan became the medical director, and Sierra Nevada Memorial Hospital agreed to become the base hospital; the hospital also provides the needed medications free of charge.

“It took a lot of meetings,” Stanley laughed. “It wasn’t easy.”

Nevada County sent him to a tactical SWAT school for paramedics, and the Nevada County Sheriff’s Office became an advanced life support provider in 2008. Stanley has been providing advanced life support on the team since.

“It’s kind of unique — only really, really large departments have what Nevada County has,” he said. “There are medics on other SWAT teams, but they’re not licensed to provide services. We’re way out in front (of the curve).”

Many law enforcement entities nationwide are integrating paramedic services into their SWAT teams — but it is more typical to use firefighters, who do not carry weapons and who do not have law enforcement training.

“Other counties have asked to use us as a template,” Stanley said. “It has started the ball rolling. It’s a new field; I think within the next 20 years, you’ll see paramedics on most teams.

“They need that — when a guy goes down, you have a very, very short time to save his life. It doesn’t do a lot of good to have someone sitting in an ambulance eight blocks away. It just delays care something fierce.”

Nevada County’s SED team, which currently has 12 members, conducts about 10 high- risk missions a year, Tripp estimated, adding it varies from year to year.

The Sheriff’s Office has a threat assessment to determine if the SED team will be called out, using criteria such as whether the person is known to have weapons, if there is a history of violence or if the person has made threats to harm someone, for instance.

While the team sometimes is used as “extra bodies” on some planned missions, such as marijuana garden eradications, typically any mission they get called out on is considered high-risk, Tripp said.

The team spends quite a bit of time training together, twice a month.

Last year, Tripp said, team members logged more than 200 training hours, including live fire range and mock training missions.

As the paramedic on the team, Stanley will carry some medical supplies in a leg pack in case “someone goes down in front of me.”

He also has a backpack full of everything a regular paramedic would have, stashed nearby for quick retrieval.

“I just don’t come with an ambulance and gurney,” he said.

Over the years, Stanley has provided medical aid that has run the gamut from sprained ankles to shootings and everything in between, he said.

“It is kind of strange,” he said. “When you go in, you’re in SWAT guy mode. But if someone gets hurt or someone is shot, I suddenly switch into paramedic mode.”